Kulig M, Klettke U, Wahn V, Forster J, Bauer C P, Wahn U
Institute of Social Medicine and Epidemiology, Charité Hospital, Humboldt University at Berlin, Berlin, Germany.
J Allergy Clin Immunol. 2000 Nov;106(5):832-9. doi: 10.1067/mai.2000.110098.
Against the background of the controversial discussion about an increase in allergic rhinitis in recent years, intraindividual longitudinal data is lacking for IgE-mediated seasonal allergic rhinitis (SAR). Little is known about the development of SAR in terms of prevalence and incidence rates from birth to school age.
In a prospective birth cohort, we investigated the development of sensitization and symptoms of SAR. SAR should be defined with high specificity, and associated risk factors should be determined.
Annual longitudinal data about seasonal allergic symptoms and sensitization was available for 587 children from birth to their seventh birthday. The definition of SAR was based on a combination of exposure-related symptoms and sensitization.
Up to 7 years of age, SAR developed in 15% of the children. Incidence and prevalence of symptoms and sensitization were low during early childhood (<2%) and increased steadily with age. Children in which SAR had already developed in the second year all were born in spring or early summer, resulting in at least two seasons of pollen exposure before manifestation of SAR. Risk factors assessed by multiple logistic regression analysis were male sex (odds ratio [OR] = 2.4), atopic mothers (OR = 2.6) and fathers (OR = 3.6) having allergic rhinitis themselves, first-born child (OR = 2.0), early sensitization to food (OR = 3.3), and atopic dermatitis (OR = 2.5), whereas early wheezing was not associated with SAR.
The development of SAR is characterized by a marked increase in prevalence and incidence after the second year of life. Our longitudinal data further indicate that in combination with the risk of allergic predisposition, at least 2 seasons of pollen allergen exposure are needed before allergic rhinitis becomes clinically manifest.
在近年来关于变应性鼻炎发病率增加的争议性讨论背景下，缺乏IgE介导的季节性变应性鼻炎（SAR）的个体纵向数据。从出生到学龄期，关于SAR的患病率和发病率的发展情况知之甚少。
在一个前瞻性出生队列中，我们调查了SAR的致敏和症状发展情况。应高特异性地定义SAR，并确定相关危险因素。
有587名儿童从出生到7岁的年度季节性过敏症状和致敏纵向数据。SAR的定义基于与暴露相关的症状和致敏的组合。
到7岁时，15%的儿童患了SAR。症状和致敏的发病率和患病率在幼儿期较低（<2%），并随年龄稳步增加。第二年就已患SAR的儿童均出生于春季或初夏，导致在SAR出现前至少有两个花粉暴露季节。通过多因素逻辑回归分析评估的危险因素为男性（比值比[OR]=2.4）、母亲（OR=2.6）和父亲（OR=3.6）患有变应性鼻炎的特应性体质儿童、头胎子女（OR=2.0）、对食物的早期致敏（OR=3.3）和特应性皮炎（OR=2.5），而早期喘息与SAR无关。
SAR的发展特点是在生命的第二年之后患病率和发病率显著增加。我们的纵向数据进一步表明，结合过敏易感性风险，在变应性鼻炎临床表现出来之前，至少需要两个花粉过敏原暴露季节。
